Pelvic Organ Prolapse :: Midlands Partnership Foundation Trust

The pelvic organs (bladder, womb, vagina and bowel) are supported and kept in place by the pelvic floor muscles and surrounding tissues. Sometimes these muscles and tissues develop problems and one or more of the organs may no longer sit in the ideal position and droop. They may bulge into the vaginal canal or even externally. This affects about one third of women over their life time.

What causes pelvic organ prolapse? Anything that puts increased pressure on the abdomen can lead to pelvic organ prolapse including:

Pregnancy and childbirth
Obesity
Respiratory problems with a chronic long term cough
Constipation
After a hysterectomy (surgical removal of the womb/uterus)
Genetics play a role

Some of the most common vaginal prolapse:

Anterior vaginal prolapse: where the anterior vaginal wall does not adequately support the bladder. This can make it difficult to fully empty the bladder, increasing risk of urinary tract infections, and can lead to an increase in symptoms of urgency
Posterior vaginal prolapse: the posterior vaginal wall doesn’t adequately support the bowel. This can make it difficult to initiate emptying or fully empty with ease
Uterine prolapse: the cervix and uterus descend into the vaginal canal

The rectum can also prolapse through the back passage (rectal prolapse).

Self Help Tips

Limit heavy lifting where you need to strain. Avoid holding your breath. Lifting from ground level is harder than from waist height.
When it can’t be avoided, before lifting, engage your pelvic floor muscles. Lift with a good posture.
Avoid constipation
Sitting position on the toilet is really helpful:
- Ideally knees should be higher that hips
- Lean forward with a straight back
- Avoid straining
- Do not hold your breath, try to breath out as you let go
Support underneath using your hand or a finger or thumb internally, to help you empty your bowels
Rock back and forward after going to the toilet to fully empty. i.e. double void.
Maintain a healthy weight
Strengthen your pelvic floor muscles, this may be easier in lying initially.
If feeling particularly heavy, lie down, knees bent, with a pillow under your bottom to allow gravity to reduce the heaviness. Do some pelvic floor exercises in this position.
Exhale with every effort. Never hold your breath or pull your tummy in strongly during an exercise